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Combination of Ketorolac and Local Anesthesia in Lumbar Spine Fusion Surgery

Spine Surgery Spine Surgery
Spine Surgery Spine Surgery

To investigate the effectiveness of the administration of Ketorolac 30 mg for managing pain and opioid usage post-spinal fusion.

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Key take away

Ketorolac + Bupivacaine reduces early post-operative pain and decreases total morphine use following posterior lumbar spine surgery.

Background

To investigate the effectiveness of the administration of Ketorolac 30 mg for managing pain and opioid usage post-spinal fusion.

Method

Patients undergoing multilevel posterolateral spinal fusion were assigned to two groups. In the control group, patients were administered Bupivacaine 0.5% injection (local anaesthetic) to paraspinal muscles before the closure of the wound. In the Ketorolac group, the patients received an additional Ketorolac 30 mg along with Bupivacaine 0.5%. Post-surgery evaluations included a numerical rating scale (NRS) for back and leg pain, morphine use, and adverse event tracking. 

Result

Forty-seven patients (mean age = 60.9 ± 6.9 years) were randomized into groups: The Ketorolac group (24 patients) and the control group (23 patients).

The average NRS for back pain was 5.8±3.0 points in the control group and 3.3±2.1 points in the Ketorolac group noted after 6 hours of the surgery. Also, lesser morphine use was prevalent in the Ketorolac group than in the other group (Table 1):

Conclusion

Adding Ketorolac to Bupivacaine for surgical wound infiltration after lumbar spine surgery relieves early post-surgical pain and lowers overall morphine use compared to bupivacaine only.

Source:

Spine

Article:

Addition of Ketorolac to Local Anesthesia for Wound Infiltration in Multilevel Posterior Lumbar Spinal Fusion: A Randomized, Double-Blinded, Placebo-controlled Trial

Authors:

Nattharut Chaibhuddanugul et al.

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